S 2709
Telehealth Modernization Act
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Bill overview
The Telehealth Modernization Act extends certain telehealth flexibilities under Medicare, primarily through 2027. It removes geographic requirements for telehealth services, expands the list of practitioners who can provide them, and extends these benefits to federally qualified health centers and rural health clinics. The bill also delays in-person requirements for mental health services delivered via telehealth and allows for audio-only telehealth services, while extending in-home cardiopulmonary rehabilitation flexibilities and addressing virtual diabetes prevention programs.
Key provisions
- Extends Medicare telehealth flexibilities through September 30, 2027.
- Removes geographic restrictions on telehealth locations.
- Expands the list of eligible practitioners to furnish telehealth services.
- Extends telehealth benefits to federally qualified health centers and rural health clinics.
- Allows for audio-only telehealth services.
- Delays in-person requirements for mental health services delivered via telehealth.
- Extends in-home cardiopulmonary rehabilitation flexibilities.
- Includes virtual diabetes prevention program suppliers in the Medicare Diabetes Prevention Program Expanded Model.
Who is affected
- Medicare beneficiaries
- Healthcare providers (physicians, nurses, hospitals)
- Federally qualified health centers
- Rural health clinics
- Health insurers
Notable changes
- Extends existing telehealth flexibilities beyond the original 2025 deadline.
Sponsors
Official sponsors from legislative records.
Primary sponsor
Cosponsors
Angus S., Jr. King
Arguments in favor
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119th CONGRESS — 1st Session
S. 2709
IN THE SENATE OF THE UNITED STATES
A BILL
To amend title XVIII of the Social Security Act to extend certain telehealth flexibilities under the Medicare program.
This Act may be cited as the Telehealth Modernization Act
.
in paragraph (2)(B)(iii), by striking ending September 30, 2025
and inserting ending September 30, 2027
; and
in paragraph (4)(C)(iii), by striking ending on September 30, 2025
and inserting ending on September 30, 2027
.
Section 1834(m)(4)(E) of the Social Security Act (42 U.S.C. 1395m(m)(4)(E)) is amended by striking ending on September 30, 2025
and inserting ending on September 30, 2027
.
Section 1834(m)(8) of the Social Security Act (42 U.S.C. 1395m(m)(8)) is amended—
in subparagraph (A), by striking ending on September 30, 2025
and inserting ending on September 30, 2027
;
in the subparagraph heading, by inserting before fiscal year 2026
after rule
;
in clause (i), by striking during the periods for which subparagraph (A) applies
and inserting before October 1, 2025
; and
in clause (ii), by inserting furnished to an eligible telehealth individual before October 1, 2025
after telehealth services
; and
by adding at the end the following new subparagraph:
on or after October 1, 2025and inserting
on or after October 1, 2027.
October 1, 2025and inserting
October 1, 2027.
October 1, 2025and inserting
October 1, 2027.
ending on September 30, 2025and inserting
ending on September 30, 2027.
by striking ending on September 30, 2025
and inserting ending on September 30, 2027
; and
, except that this subclause shall not apply in the case of such an encounter with an individual occurring on or after September 30, 2025, if such individual is located in an area that is subject to a moratorium on the enrollment of hospice programs under this title pursuant to section 1866(j)(7), if such individual is receiving hospice care from a provider that is subject to enhanced oversight under this title pursuant to section 1866(j)(3), or if such encounter is performed by a hospice physician or nurse practitioner who is not enrolled under section 1866(j) and is not an opt-out physician or practitioner (as defined in section 1802(b)(6)(D))before the semicolon.
Section 1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C. 1395f(a)(7)(D)(i)(II)), as amended by section 2(f), is further amended by inserting , but only if, in the case of such an encounter occurring on or after January 1, 2026, any hospice claim includes 1 or more modifiers or codes (as specified by the Secretary) to indicate that such encounter was conducted via telehealth
after as determined appropriate by the Secretary
.
2025and inserting
2030.
Section 1866G of the Social Security Act (42 U.S.C. 1395cc–7), as amended by subsection (a), is further amended—
in subsection (b), in the subsection heading, by striking Study
and inserting Initial study
;
by redesignating subsections (c) and (d) as subsections (d) and (e), respectively; and
by inserting after subsection (b) the following new subsection:
analyze and compare (both within and between hospitals participating in the initiative, and relative to comparable hospitals that do not participate in the initiative, for relevant parameters such as diagnosis-related groups)—
quality of care furnished to individuals with similar conditions and characteristics in the inpatient setting and through the Acute Hospital Care at Home initiative, including health outcomes, hospital readmission rates (including readmissions both within and beyond 30 days post-discharge), hospital mortality rates, length of stay, infection rates, composition of care team (including the types of labor used, such as contracted labor), the ratio of nursing staff, transfers from the hospital to the home, transfers from the home to the hospital (including the timing, frequency, and causes of such transfers), transfers and discharges to post-acute care settings (including the timing, frequency, and causes of such transfers and discharges), and patient and caregiver experience of care;
clinical conditions treated and diagnosis-related groups of discharges from inpatient settings relative to discharges from the Acute Hospital Care at Home initiative;
costs incurred by the hospital for furnishing care in inpatient settings relative to costs incurred by the hospital for furnishing care through the Acute Hospital Care at Home initiative, including costs relating to staffing, equipment, food, prescriptions, and other services, as determined by the Secretary;
the quantity, mix, and intensity of services (such as in-person visits and virtual contacts with patients and the intensity of such services) furnished in inpatient settings relative to the Acute Hospital Care at Home initiative, and, to the extent practicable, the nature and extent of family or caregiver involvement;
socioeconomic information on individuals treated in comparable inpatient settings relative to the initiative, including racial and ethnic data, income, housing, geographic proximity to the brick-and-mortar facility and whether such individuals are dually eligible for benefits under this title and title XIX; and
In conducting the study under paragraph (1), the Secretary shall, to the extent practicable, analyze and compare individuals who participate and do not participate in the initiative controlling for selection bias or other factors that may impact the reliability of data.
Not later than September 30, 2028, the Secretary of Health and Human Services shall submit to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate a report on the study conducted under paragraph (1).
With respect to items furnished on or after January 1, 2028, that are included on the Master List pursuant to subparagraph (A), if such an item is not subject to a determination of coverage in advance pursuant to paragraph (15)(C), the Secretary may conduct prepayment review of claims for payment for such item.
, and paragraph (23) of subsection (a) shall apply to prosthetic devices, orthotics, and prosthetics in the same manner as such provision applies to items for which payment may be made under such subsectionbefore the period at the end.
which, if any, clinical diagnostic laboratory tests are identified as being at high risk of fraudulent claims, and an analysis of the factors that contribute to such risk;
with respect to a clinical diagnostic laboratory test identified under paragraph (1) as being at high risk of fraudulent claims—
the amount payable under such section 1834A with respect to such test;
whether an order for such a test was more likely to come from a provider with whom the individual involved did not have a prior relationship, as determined on the basis of prior payment experience; and
the frequency with which a claim for payment under such section 1834A included the payment modifier identified by code 59 or 91;
suggested strategies for reducing the number of fraudulent claims made with respect to tests so identified as being at high risk, including—
an analysis of whether the Centers for Medicare & Medicaid Services can detect aberrant billing patterns with respect to such tests in a timely manner;
any strategies for identifying and monitoring the providers who are outliers with respect to the number of such tests that such providers order; and
targeted education efforts to mitigate improper billing for such tests; and
such other information as the Inspector General determines appropriate.
Best practices on providing accessible instructions on how to access telecommunications systems (as such term is used for purposes of section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m))) for individuals with limited English proficiency.
Best practices on improving access to digital patient portals for individuals with limited English proficiency.
Best practices on integrating the use of video platforms that enable multi-person video calls furnished via a telecommunications system for purposes of providing interpretation during a telemedicine appointment for an individual with limited English proficiency.
Best practices for providing patient materials, communications, and instructions in multiple languages, including text message appointment reminders and prescription information.
For purposes of subsection (a), an entity described in this subsection is an entity in 1 or more of the following categories:
electronic medical record companies;
remote patient monitoring companies; and
telehealth or mobile health vendors and companies.
Health care providers, including—
physicians; and
hospitals.
Health insurers.
Language service companies.
Interpreter or translator professional associations.
Health and language services quality certification organizations.
Patient and consumer advocates, including such advocates that work with individuals with limited English proficiency.
in subparagraph (A)(ii), by inserting (including, with respect to items and services furnished through audio and video real-time communications technology (excluding audio-only) on or after September 30, 2025, and before January 1, 2027, in the home of an individual who is an outpatient of the hospital)
after outpatient basis
; and
in subparagraph (B), by inserting (including, with respect to items and services furnished through audio and video real-time communications technology on or after September 30, 2025, and before January 1, 2027, the virtual presence of such physician, physician assistant, nurse practitioner, or clinical nurse specialist)
after under the program
.
Notwithstanding any other provision of law, the Secretary of Health and Human Services may implement the amendments made by this section by program instruction or otherwise.
Not later than January 1, 2026, the Secretary shall revise the regulations under parts 410 and 424 of title 42, Code of Federal Regulations, to provide that, for the period beginning January 1, 2026, and ending December 31, 2030—
if an entity participates in the MDPP in the manner described in paragraph (1)—
the administrative location of such entity shall be the address of the entity on file under the Diabetes Prevention Recognition Program; and
in the case of online MDPP services furnished by such entity to an MDPP beneficiary who was not located in the same State as the entity at the time such services were furnished, the entity shall not be prohibited from submitting a claim for payment for such services solely by reason of the location of such beneficiary at such time; and
no limit is applied on the number of times an individual may enroll in the MDPP.
In this section:
Medicare and Medicaid Programs; CY 2024 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Advantage; Medicare and Medicaid Provider and Supplier Enrollment Policies; and Basic Health Program(88 Fed. Reg. 78818 (November 16, 2023)) (or a successor regulation).
The terms Diabetes Prevention Recognition Program, MDPP beneficiary, MDPP services, and MDPP supplier have the meanings given each such term in section 410.79(b) of title 42, Code of Federal Regulations.
The term Secretary means the Secretary of Health and Human Services.